JP2013527218A - Oral vaccine containing antigen and Toll-like receptor agonist - Google Patents
Oral vaccine containing antigen and Toll-like receptor agonist Download PDFInfo
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- JP2013527218A JP2013527218A JP2013512932A JP2013512932A JP2013527218A JP 2013527218 A JP2013527218 A JP 2013527218A JP 2013512932 A JP2013512932 A JP 2013512932A JP 2013512932 A JP2013512932 A JP 2013512932A JP 2013527218 A JP2013527218 A JP 2013527218A
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Abstract
本発明は、経口(例えば舌下)投与組成物中に1以上の抗原およびToll様受容体(TLR)アゴニストを含有する免疫原性組成物を提供する。 The present invention provides an immunogenic composition containing one or more antigens and a Toll-like receptor (TLR) agonist in an oral (eg sublingual) administration composition.
Description
本発明は、経口送達に適した免疫原性組成物を提供する。 The present invention provides an immunogenic composition suitable for oral delivery.
一般的に、患者のワクチン接種のコンプライアンスを向上させ、ワクチンの製造および輸送の容易さを改善する必要がある。経口免疫は、これらの必要性のいくつかに対処することができ、アジュバントとともに抗原を投与して、抗原特異的な免疫応答を誘導するために使用され得る(例えば、WO99/21579参照)。 In general, there is a need to improve patient vaccination compliance and improve the ease of vaccine manufacture and transport. Oral immunization can address some of these needs and can be used to administer an antigen with an adjuvant to induce an antigen-specific immune response (see, eg, WO99 / 21579).
本発明は、経口投与組成物中に1つ以上の抗原およびToll様受容体(TLR)アゴニストを含有する免疫原性組成物ならびにそれらの医療分野での使用を提供する。 The present invention provides immunogenic compositions containing one or more antigens and Toll-like receptor (TLR) agonists in oral administration compositions and their use in the medical field.
本発明は、経口投与組成物中に1つ以上の抗原およびToll様受容体(TLR)アゴニストを含有する免疫原性組成物を提供する。 The present invention provides an immunogenic composition containing one or more antigens and a Toll-like receptor (TLR) agonist in an orally administered composition.
本発明は、口腔内で迅速に崩壊するように設計された経口投与固体分散剤型中に、1つ以上の抗原およびToll様受容体(TLR)アゴニストを含有する免疫原性組成物を提供する。 The present invention provides an immunogenic composition containing one or more antigens and a Toll-like receptor (TLR) agonist in an orally administered solid dispersion form designed to disintegrate rapidly in the oral cavity. .
本発明の更なる実施形態では、前記の組成物を経口投与、特に舌下投与するステップを含む免疫方法に使用するために、本明細書に定義されるような免疫原性組成物が提供される。本発明の更なる実施形態では、1つ以上の抗原およびToll様受容体(TLR)アゴニストを含有する、経口(特に舌下)投与に適した、本明細書に定義されるような免疫原性組成物が提供される。本発明の更に別の実施形態では、1つ以上の抗原およびToll様受容体(TLR)アゴニストを含有する、本明細書に定義されるような経口(特に舌下)投与免疫原性組成物が提供される。 In a further embodiment of the present invention there is provided an immunogenic composition as defined herein for use in an immunization method comprising the step of administering said composition orally, in particular sublingually. The In a further embodiment of the invention, immunogenicity as defined herein suitable for oral (especially sublingual) administration, comprising one or more antigens and a Toll-like receptor (TLR) agonist. A composition is provided. In yet another embodiment of the invention, an oral (especially sublingual) administered immunogenic composition as defined herein comprising one or more antigens and a Toll-like receptor (TLR) agonist. Provided.
本発明の更なる態様では、医薬に使用するための本明細書に定義されるような免疫原性組成物が提供される。 In a further aspect of the invention there is provided an immunogenic composition as defined herein for use in medicine.
本発明の更なる態様では、疾患の治療および/または予防に使用するための本明細書に定義されるような免疫原性組成物が提供される。 In a further aspect of the invention there is provided an immunogenic composition as defined herein for use in the treatment and / or prevention of diseases.
「経口投与」、「経口投与される」、「経口ワクチン接種」、「経口免疫」、「経口送達」という用語は、本明細書において用いられる場合、口腔内への抗原の適用を指すことを意図し、そこで抗原を含有する免疫原性組成物は、頬咽頭領域の粘膜組織での免疫応答を促進する形で吸着される。誤解を避けるために、これらの用語は、摂取、すなわち、抗原が飲み込まれる、または他の任意の方法で胃に入ることによる抗原の投与を包含しない。特定の実施形態では、本発明の免疫原性組成物は、舌下投与、すなわち舌の下に投与される。 The terms “oral administration”, “orally administered”, “oral vaccination”, “oral immunization”, “oral delivery”, as used herein, refer to the application of an antigen to the oral cavity. Intentionally, the immunogenic composition containing the antigen is adsorbed in a manner that promotes an immune response in mucosal tissue of the bucopharyngeal region. For the avoidance of doubt, these terms do not encompass ingestion, ie administration of the antigen by swallowing the antigen or entering the stomach in any other way. In certain embodiments, the immunogenic compositions of the invention are administered sublingually, ie sublingually.
「経口(例えば、舌下)投与組成物」は、本明細書において用いられる場合、口腔内に投与される組成物を指すことを意図し、そこで免疫原性組成物または抗原を含有する組成物の少なくとも抗原成分は、頬咽頭領域の粘膜組織での免疫応答を促進する方法で吸着される。誤解を避けるために、これらの用語は、摂取、すなわち、抗原が飲み込まれる、もしくは他の任意の方法で胃に入ることによって、または当業者に知られている免疫原性組成物の他の任意の投与方法(例えば、筋肉内、皮内、鼻腔内もしくは経皮投与)によって投与される組成物を包含しない。特定の実施形態では、本発明の免疫原性組成物は、舌下投与、すなわち舌の下に投与される。 “Oral (eg, sublingual) administration composition” as used herein is intended to refer to a composition that is administered orally, wherein the composition contains an immunogenic composition or antigen. At least the antigenic component of is adsorbed in a manner that promotes an immune response in mucosal tissue of the bucopharyngeal region. To avoid misunderstanding, these terms may be taken by ingestion, i.e. by swallowing the antigen or entering the stomach in any other way, or any other immunogenic composition known to those skilled in the art. Compositions administered by any of the methods of administration (eg, intramuscular, intradermal, intranasal or transdermal). In certain embodiments, the immunogenic compositions of the invention are administered sublingually, ie sublingually.
経口投与免疫原性組成物は、液体または固体投与剤型でありうる。本発明の特定の実施形態では、免疫原性組成物は、口腔内で迅速に崩壊する固体投与剤型である。免疫原性組成物は、口腔内で迅速に崩壊する固体分散剤型である。崩壊後、投与剤型の成分は、粘膜関連リンパ組織を包括するように頬咽頭領域の粘膜組織を迅速に覆い、それと接触して保持される。これにより、抗原成分が、抗原の吸収が可能な組織と接触する。本発明の特定の実施形態では、口腔内に置かれて約1〜約60秒以内、特に約1〜約30秒以内、約1〜約10秒以内または約2〜8秒以内に崩壊する固体投与剤型である免疫原性組成物が提供される。通常、崩壊時間は37℃の水中で60秒未満であり、これは米国薬局方第23版、1995に規定された崩壊方法に従って試験され得る。 Orally administered immunogenic compositions can be in liquid or solid dosage form. In certain embodiments of the invention, the immunogenic composition is a solid dosage form that disintegrates rapidly in the oral cavity. The immunogenic composition is a solid dispersion form that disintegrates rapidly in the oral cavity. After disintegration, the dosage form components rapidly cover and hold in contact with the mucosal tissue of the bucopharyngeal region to encompass the mucosa-associated lymphoid tissue. Thereby, an antigen component contacts the tissue which can absorb an antigen. In certain embodiments of the invention, a solid that is placed in the oral cavity and disintegrates within about 1 to about 60 seconds, particularly within about 1 to about 30 seconds, within about 1 to about 10 seconds, or within about 2 to 8 seconds. An immunogenic composition that is in dosage form is provided. Typically, the disintegration time is less than 60 seconds in water at 37 ° C., which can be tested according to the disintegration method specified in US Pharmacopeia 23rd edition, 1995.
特定の実施形態では、経口投与免疫原性組成物は、粘膜付着性物質を含有する。適切な固体投与剤型は、WO1999/021579(EP1024824B1)に記載される。 In certain embodiments, the orally administered immunogenic composition contains a mucoadhesive substance. Suitable solid dosage forms are described in WO1999 / 021579 (EP1024824B1).
本発明の特定の実施形態では、粘膜付着性物質を含有する製剤が提供され、そこで粘膜付着性物質は、以下の群、すなわち、ポリアクリル酸ポリマー、セルロースおよびその誘導体または天然高分子(例えばゼラチン、アルギン酸ナトリウムおよびペクチン)より選択される。特定の実施形態では、粘膜付着性物質は、キトサンまたはその誘導体、でんぷんおよびその誘導体、ヒアルロン酸およびその誘導体、アルギン酸ナトリウム、ゼラチン、ポリガラクツロン酸ナトリウム、デキストラン、マンナン、セルロースフィルム、合成非分解性ポリマー、ポリアクリル酸系ポリマー、カーボポールまたはそれらの組合せからなる群より選択される。 In a particular embodiment of the invention, a formulation containing a mucoadhesive substance is provided, wherein the mucoadhesive substance comprises the following groups: polyacrylic acid polymer, cellulose and its derivatives or natural polymers (eg gelatin , Sodium alginate and pectin). In certain embodiments, the mucoadhesive substance is chitosan or a derivative thereof, starch and a derivative thereof, hyaluronic acid and a derivative thereof, sodium alginate, gelatin, sodium polygalacturonate, dextran, mannan, cellulose film, synthetic non-degradable polymer , A polyacrylic acid polymer, carbopol or a combination thereof.
本発明の更なる実施形態では、免疫原性組成物は、抗原およびアジュバントに加えて、マトリックス形成剤および補助的な成分を含有する。本発明での使用に適したマトリックス形成剤は、ゼラチン、デキストリンならびにダイズ、コムギおよびオオバコ種子タンパク質などの動物性または植物性タンパク質に由来する物質;アカシア、グアー、寒天およびキサンタンなどのゴム;多糖類;アルギン酸;カルボキシメチルセルロース;カラギーナン;デキストラン;ペクチン;ポリビニルピロリドンなどの合成ポリマー;ならびにゼラチン‐アカシア複合体のようなポリペプチド/タンパク質または多糖類の複合体を含む。本発明での使用に適した他のマトリックス形成剤は、マンニトール、デキストロース、ラクトース、ガラクトースおよびトレハロースなどの糖類;シクロデキストリンなどの環状糖類;リン酸ナトリウム、塩化ナトリウムおよびケイ酸アルミニウムなどの無機塩類;ならびにグリシン、L-アラニン、L-アスパラギン酸、L-グルタミン酸、L-ヒドロキシプロリン、L-イソロイシン、L-ロイシンおよびL-フェニルアラニンなどの2〜12炭素原子を有するアミノ酸を含む。1種以上のマトリックス形成剤が、固形化前の溶液または懸濁液中に組み込まれうる。マトリックス形成剤は、界面活性剤とともに、または界面活性剤を含まずに存在しうる。マトリックスの形成に加えて、マトリックス形成剤は、溶液または懸濁液中での任意の活性成分の分散を維持するために役立ちうる。これは特に、水に十分溶解できず、そのため、溶解ではなく懸濁されなければならない抗原の場合に有用である。 In a further embodiment of the invention, the immunogenic composition contains a matrix-forming agent and auxiliary components in addition to the antigen and adjuvant. Matrix-forming agents suitable for use in the present invention include gelatin, dextrin and materials derived from animal or vegetable proteins such as soybean, wheat and psyllium seed proteins; gums such as acacia, guar, agar and xanthan; polysaccharides Carboxymethylcellulose; carrageenan; dextran; pectin; synthetic polymers such as polyvinylpyrrolidone; and polypeptide / protein or polysaccharide conjugates such as gelatin-acacia conjugates. Other matrix forming agents suitable for use in the present invention include saccharides such as mannitol, dextrose, lactose, galactose and trehalose; cyclic saccharides such as cyclodextrin; inorganic salts such as sodium phosphate, sodium chloride and aluminum silicate; As well as amino acids having 2 to 12 carbon atoms such as glycine, L-alanine, L-aspartic acid, L-glutamic acid, L-hydroxyproline, L-isoleucine, L-leucine and L-phenylalanine. One or more matrix forming agents can be incorporated into the solution or suspension prior to solidification. The matrix forming agent may be present with or without a surfactant. In addition to forming the matrix, the matrix forming agent can help to maintain the dispersion of any active ingredient in the solution or suspension. This is particularly useful for antigens that are not sufficiently soluble in water and therefore must be suspended rather than dissolved.
免疫原性組成物の更なる実施形態では、更に、保存剤、抗酸化剤、界面活性剤、増粘剤、着色剤、香味剤、pH調整剤、甘味剤または矯味剤などの補助的な成分もまた、組成物中に組み込まれうる。適切な着色剤は、赤色、黒色および黄色酸化鉄、ならびにEllis & Everard社から入手可能な FD & C青色2号およびFD & C赤色40号などのFD & C色素を含む。適切な香味剤は、ミント、ラズベリー、リコリス、オレンジ、レモン、グレープフルーツ、キャラメル、バニラ、サクランボおよびブドウ香味剤ならびにそれらの組合せを含む。適切なpH調整剤は、クエン酸、酒石酸、リン酸、塩酸およびマレイン酸を含む。適切な甘味剤は、アスパルテーム、アセスルファムKおよびタウマチン(thaumatic)を含む。適切な矯味剤は、重炭酸ナトリウム、イオン交換樹脂、シクロデキストリン包接化合物、吸着質またはマイクロカプセル化活性物質を含む。 In further embodiments of the immunogenic composition, further auxiliary ingredients such as preservatives, antioxidants, surfactants, thickeners, colorants, flavoring agents, pH adjusting agents, sweeteners or flavoring agents. Can also be incorporated into the composition. Suitable colorants include red, black and yellow iron oxides and FD & C dyes such as FD & C Blue No. 2 and FD & C Red No. 40 available from Ellis & Everard. Suitable flavoring agents include mint, raspberry, licorice, orange, lemon, grapefruit, caramel, vanilla, cherry and grape flavoring and combinations thereof. Suitable pH adjusting agents include citric acid, tartaric acid, phosphoric acid, hydrochloric acid and maleic acid. Suitable sweeteners include aspartame, acesulfame K and thaumatic. Suitable flavoring agents include sodium bicarbonate, ion exchange resins, cyclodextrin inclusion compounds, adsorbates or microencapsulated active substances.
本発明の免疫原性組成物は抗原を含有し、それはヒトもしくは動物病原体、またはヒトもしくは動物において発病を引き起こす物質に対する免疫応答を誘導することができる。 The immunogenic compositions of the present invention contain an antigen, which can induce an immune response against a human or animal pathogen, or a substance that causes disease in a human or animal.
「抗原」という用語は、当業者にとって周知である。抗原は、ヒトもしくは動物において免疫応答を引き起こすことができるタンパク質、多糖類、ペプチド、核酸、タンパク質‐多糖類コンジュゲート、分子またはハプテンであり得る。抗原は、ウイルス、細菌、寄生生物、原生動物もしくは真菌に由来するものであっても、相同であっても、または分子を模倣するように合成されてもよい。免疫原性組成物は、1つ以上の抗原を含んでもよく、その実施形態では、抗原は、同一の生物から採取されてもよく、異なる生物から採取されてもよい。本発明の特定の実施形態では、抗原はインフルエンザに由来する。 The term “antigen” is well known to those skilled in the art. An antigen can be a protein, polysaccharide, peptide, nucleic acid, protein-polysaccharide conjugate, molecule or hapten capable of causing an immune response in a human or animal. Antigens can be derived from viruses, bacteria, parasites, protozoa or fungi, can be homologous, or can be synthesized to mimic molecules. The immunogenic composition may comprise one or more antigens, and in that embodiment the antigens may be collected from the same organism or from different organisms. In certain embodiments of the invention, the antigen is derived from influenza.
本発明の免疫原性組成物は、Toll様受容体アゴニストを含有する。「TLRアゴニスト」とは、直接リガンドとして、または間接的に内因性もしくは外因性リガンドの生成を介して、TLRシグナル伝達経路を介したシグナル伝達応答を引き起こすことができる成分を意味する(Sabroeら、JI 2003 p1630-5)。 The immunogenic composition of the present invention contains a Toll-like receptor agonist. By “TLR agonist” is meant a component that can trigger a signaling response through the TLR signaling pathway, either directly as a ligand or indirectly through the generation of an endogenous or exogenous ligand (Sabroe et al., JI 2003 p1630-5).
Toll様受容体(TLR)は、I型膜貫通受容体であり、昆虫からヒトの間で進化的に保存されている。これまでに10個のTLRが解明されている(TLR 1〜10)(Sabroeら、JI 2003 p1630-5)。TLRファミリーのメンバーは、類似の細胞外ドメインおよび細胞内ドメインを有し;それらの細胞外ドメインは、ロイシンに富む反復配列を有することが示されており、それらの細胞内ドメインは、インターロイキン-1受容体(IL-1R)の細胞内領域と類似している。TLR細胞は、免疫細胞と他の細胞(血管上皮細胞、脂肪細胞、心筋細胞および腸上皮細胞を含む)との間で異なって発現される。TLRの細胞内ドメインは、その細胞質領域にIL-1Rドメインも有するアダプタータンパク質Myd88と相互作用することができ、サイトカインのNF-κB活性化を引き起こし;このMyd88経路は、サイトカイン放出がTLR活性化によってもたらされる1つの方法である。TLRの主な発現は、抗原提示細胞(例えば、樹状細胞、マクロファージなど)のような細胞型においてである。 The Toll-like receptor (TLR) is a type I transmembrane receptor and is evolutionarily conserved between insects and humans. So far, 10 TLRs have been elucidated (TLR 1-10) (Sabroe et al., JI 2003 p1630-5). Members of the TLR family have similar extracellular and intracellular domains; these extracellular domains have been shown to have leucine-rich repeats, and their intracellular domains are interleukin- It is similar to the intracellular region of 1 receptor (IL-1R). TLR cells are differentially expressed between immune cells and other cells, including vascular epithelial cells, adipocytes, cardiomyocytes and intestinal epithelial cells. The intracellular domain of TLR can interact with the adapter protein Myd88, which also has an IL-1R domain in its cytoplasmic region, causing cytokine NF-κB activation; this Myd88 pathway is responsible for cytokine release by TLR activation One way that is brought about. The main expression of TLR is in cell types such as antigen presenting cells (eg, dendritic cells, macrophages, etc.).
TLRを介した刺激による樹状細胞の活性化は、樹状細胞の成熟およびIL-12などの炎症性サイトカインの産生を引き起こす。これまでに行われた研究では、いくつかのアゴニストはいくつかのTLR に共通であるが、TLRは異なる種類のアゴニストを認識することが発見されている。TLRアゴニストは、主に細菌またはウイルスに由来し、フラジェリンまたは細菌性リポ多糖類(LPS)などの分子を含む。 Activation of dendritic cells by stimulation through TLRs causes maturation of dendritic cells and production of inflammatory cytokines such as IL-12. Previous studies have found that some agonists are common to several TLRs, but TLRs recognize different types of agonists. TLR agonists are primarily derived from bacteria or viruses and include molecules such as flagellin or bacterial lipopolysaccharide (LPS).
ある実施形態では、toll様受容体アゴニストは、Toll様受容体(TLR)4アゴニストであり、好ましくは、リピドA誘導体、具体的にはモノホスホリルリピドAまたはより具体的には3脱アシル化モノホスホリルリピドA(3D-MPL)などのアゴニストである。 In certain embodiments, the toll-like receptor agonist is a Toll-like receptor (TLR) 4 agonist, preferably a lipid A derivative, specifically monophosphoryl lipid A or more specifically 3 deacylated mono An agonist such as phosphoryl lipid A (3D-MPL).
3D-MPLは、MPL(登録商標)という商標でGlaxoSmithKline Biologicals North Americaから入手可能であり、主にIFN-γ(Th1)表現型を有するCD4+ T細胞応答を促進する。それは、GB 2 220 211 Aに開示される方法に従って生成され得る。化学的には、それは、3、4、5または6アシル化された鎖を有する3-脱アシル化モノホスホリルリピドAの混合物である。好ましくは、本発明の組成物では、小粒子3D-MPLが使用される。小粒子3D-MPLは、0.22μmフィルターによってろ過滅菌されうるような粒径を有する。このような調製物は、国際特許出願番号WO 94/21292に記載される。リピドAの合成誘導体は公知であり、下記を含むがそれらに限定されないTLR 4アゴニストであると考えられる。すなわち、
OM174(2-デオキシ-6-o-[2-デオキシ-2-[(R)-3-ドデカノイルオキシテトラ-デカノイルアミノ]-4-o-ホスホノ-β-D-グルコピラノシル]-2-[(R)-3-ヒドロキシテトラデカノイルアミノ]-α-D-グルコピラノシルジハイドロジェンホスフェート)、(WO 95/14026)。
3D-MPL is available from GlaxoSmithKline Biologicals North America under the trademark MPL® and promotes a CD4 + T cell response with a predominantly IFN-γ (Th1) phenotype. It can be produced according to the method disclosed in
OM174 (2-deoxy-6-o- [2-deoxy-2-[(R) -3-dodecanoyloxytetra-decanoylamino] -4-o-phosphono-β-D-glucopyranosyl] -2- [ (R) -3-hydroxytetradecanoylamino] -α-D-glucopyranosyl dihydrogen phosphate), (WO 95/14026).
OM 294 DP (3S, 9R)-3-[(R)-ドデカノイルオキシテトラデカノイルアミノ]-4-オキソ-5-アザ-9(R)-[(R)-3-ヒドロキシテトラデカノイルアミノ]デカン-1,10-ジオール,1,10-ビス(ジハイドロジェンホスフェート)(WO99 /64301およびWO 00/0462)。 OM 294 DP (3S, 9R) -3-[(R) -Dodecanoyloxytetradecanoylamino] -4-oxo-5-aza-9 (R)-[(R) -3-hydroxytetradecanoylamino Decane-1,10-diol, 1,10-bis (dihydrogen phosphate) (WO99 / 64301 and WO 00/0462).
OM 197 MP-Ac DP (3S-,9R)-3-[(R)-ドデカノイルオキシテトラデカノイルアミノ]-4-オキソ-5-アザ-9-[(R)-3-ヒドロキシテトラデカノイルアミノ]デカン-1,10-ジオール,1-ジハイドロジェンホスフェート10-(6-アミノヘキサノエート) (WO 01/46127)。 OM 197 MP-Ac DP (3S-, 9R) -3-[(R) -Dodecanoyloxytetradecanoylamino] -4-oxo-5-aza-9-[(R) -3-hydroxytetradecanoyl Amino] decane-1,10-diol, 1-dihydrogen phosphate 10- (6-aminohexanoate) (WO 01/46127).
使用されうる他のTLR4リガンドは、WO9850399もしくはUS6303347(AGPを調製するための方法もまた開示される)に開示されたもののようなアルキルグルコサミニドホスフェート(AGP)、またはUS6764840に開示されるような製薬上許容されうるAGPの塩である。いくつかのAGPはTLR4アゴニストであり、いくつかはTLR4アンタゴニストである。両方とも、アジュバントとして有用であると考えられる。本発明の特定の実施形態では、アジュバントは、AGPであるTLR-4アゴニストである。特定の実施形態では、TLR4アゴニストはCRX524またはCRX527である。CRX527およびCRX524は、以前に記載されている(米国特許第6,113,918号;実施例15および16、ならびにWO 2006/012425、WO 2006/016997参照)。 Other TLR4 ligands that can be used are alkyl glucosaminide phosphates (AGP) such as those disclosed in WO9850399 or US6303347 (methods for preparing AGP are also disclosed), or as disclosed in US6764840 It is a pharmaceutically acceptable salt of AGP. Some AGPs are TLR4 agonists and some are TLR4 antagonists. Both are considered useful as adjuvants. In certain embodiments of the invention, the adjuvant is a TLR-4 agonist that is AGP. In certain embodiments, the TLR4 agonist is CRX524 or CRX527. CRX527 and CRX524 have been previously described (see US Pat. No. 6,113,918; Examples 15 and 16, and WO 2006/012425, WO 2006/016997).
TLR-4(Sabroeら、JI 2003 p1630-5)を介したシグナル伝達応答を引き起こすことができる他の適切なTLR-4リガンドは、例えば、グラム陰性細菌由来のリポ多糖類およびその誘導体、またはその断片、特にLPSの非毒性誘導体(3D-MPLなど)である。他の適切なTLRアゴニストは:熱ショックタンパク質(HSP)10、60、65、70、75もしくは90;サーファクタントタンパク質A、ヒアルロン酸オリゴ糖、ヘパラン硫酸断片、フィブロネクチン断片、フィブリノゲンペプチドおよびb-ディフェンシン-2、ムラミルジペプチド(MDP)または呼吸器合胞体ウイルスのFタンパク質である。1つの実施形態では、TLRアゴニストは、HSP 60、70または90である。 Other suitable TLR-4 ligands that can trigger a signaling response through TLR-4 (Sabroe et al., JI 2003 p1630-5) are, for example, lipopolysaccharides and derivatives thereof from Gram-negative bacteria, or their Fragments, especially non-toxic derivatives of LPS (such as 3D-MPL). Other suitable TLR agonists are: heat shock protein (HSP) 10, 60, 65, 70, 75 or 90; surfactant protein A, hyaluronic acid oligosaccharide, heparan sulfate fragment, fibronectin fragment, fibrinogen peptide and b-defensin-2 Muramyl dipeptide (MDP) or respiratory syncytial virus F protein. In one embodiment, the TLR agonist is HSP 60, 70 or 90.
本発明の更なる実施形態では、TLRアゴニストは、TLR2アゴニスト(Sabroeら、JI 2003 p1630-5)である。適切には、TLR-2を介したシグナル伝達応答を引き起こすことができるTLRアゴニストは、1つ以上のリポタンパク質、ペプチドグリカン、M. tuberculosis、B. burgdorferi、 T. pallidumに由来する細菌性リポペプチド;Staphylococcus aureusなどの種に由来するペプチドグリカン;リポテイコ酸、マンヌロン酸、Neisseriaのポリン、細菌線毛、Yersinaの毒性因子、CMVビリオン、麻疹赤血球凝集素、および酵母由来のザイモサンである。本発明の特定の実施形態では、TLR2アゴニストは、合成リポペプチドPam3Cys-Lipである(例えば、Fisetteら、Journal of Biological Chemistry 278(47) 46252参照)。 In a further embodiment of the invention, the TLR agonist is a TLR2 agonist (Sabroe et al., JI 2003 p1630-5). Suitably, the TLR agonist capable of triggering a signaling response via TLR-2 is a bacterial lipopeptide derived from one or more lipoproteins, peptidoglycan, M. tuberculosis, B. burgdorferi, T. pallidum; Peptidoglycans from species such as Staphylococcus aureus; lipoteichoic acid, mannuronic acid, Neisseria porins, bacterial pili, Yersina virulence factors, CMV virions, measles hemagglutinin, and yeast-derived zymosan. In certain embodiments of the invention, the TLR2 agonist is the synthetic lipopeptide Pam3Cys-Lip (see, eg, Fisette et al., Journal of Biological Chemistry 278 (47) 46252).
本発明の更なる実施形態では、本発明の免疫原性組成物は、TLR4アゴニストおよびTLR2アゴニストを含有する。特定の実施形態では、本発明の免疫原性組成物は、Shigella flexineri外膜タンパク質調製物(SFOMP)を含有する。特定の実施形態では、免疫原性組成物は、AGP(例えばCRX-527)などのTLR4アゴニストおよびTLR2アゴニストPam3CysLipを含有する。 In a further embodiment of the invention, the immunogenic composition of the invention contains a TLR4 agonist and a TLR2 agonist. In certain embodiments, the immunogenic compositions of the invention contain a Shigella flexineri outer membrane protein preparation (SFOMP). In certain embodiments, the immunogenic composition contains a TLR4 agonist such as AGP (eg, CRX-527) and a TLR2 agonist Pam3CysLip.
本発明の免疫原性組成物は、TLR1、TLR2、TLR3、TLR4、TLR5、TLR6、TLR7、TLR8もしくはTLR9アゴニストまたはそれらの組合せを含有しうる。 The immunogenic composition of the invention may contain a TLR1, TLR2, TLR3, TLR4, TLR5, TLR6, TLR7, TLR8 or TLR9 agonist or combinations thereof.
本発明の1つの実施形態では、TLR-1(Sabroeら、JI 2003 p1630-5)を介したシグナル伝達応答を引き起こすことができるTLRアゴニストが使用される。適切には、TLR-1を介したシグナル伝達応答を引き起こすことができるTLRアゴニストは:トリアシル化リポペプチド(LP);フェノール可溶性モジュリン;Mycobacterium tuberculosis LP;細菌性リポタンパク質のアセチル化アミノ末端を模倣するS-(2,3-ビス(パルミトイルオキシ)-(2-RS)-プロピル)-N-パルミトイル-(R)-Cys-(S)-Ser-(S)-Lys(4)-OH、三塩酸(Pam3Cys)LPおよびBorrelia burgdorfei由来のOspA LPより選択される。 In one embodiment of the invention, a TLR agonist is used that is capable of causing a signaling response through TLR-1 (Sabroe et al., JI 2003 p1630-5). Suitably, TLR agonists that can trigger a TLR-1 mediated signaling response: triacylated lipopeptides (LP); phenol soluble modulins; Mycobacterium tuberculosis LP; mimics the acetylated amino terminus of bacterial lipoproteins S- (2,3-bis (palmitoyloxy)-(2-RS) -propyl) -N-palmitoyl- (R) -Cys- (S) -Ser- (S) -Lys (4) -OH, three Selected from hydrochloric acid (Pam 3 Cys) LP and OspA LP from Borrelia burgdorfei.
別の実施形態では、TLR-3(Sabroeら、JI 2003 p1630-5)を介したシグナル伝達応答を引き起こすことができるTLRアゴニストが使用される。適切には、TLR-3を介したシグナル伝達応答を引き起こすことができるTLRアゴニストは、二本鎖RNA(dsRNA)、またはウイルス感染に関連した分子核酸パターンであるポリイノシン‐ポリシチジル酸(Poly IC)である。 In another embodiment, a TLR agonist is used that is capable of causing a signaling response through TLR-3 (Sabroe et al., JI 2003 p1630-5). Suitably, TLR agonists that can trigger TLR-3 mediated signaling responses are double-stranded RNA (dsRNA) or polyinosine-polycytidylic acid (Poly IC), a molecular nucleic acid pattern associated with viral infection. is there.
別の実施形態では、TLR-5(Sabroeら、JI 2003 p1630-5)を介したシグナル伝達応答を引き起こすことができるTLRアゴニストが使用される。適切には、TLR-5を介したシグナル伝達応答を引き起こすことができるTLRアゴニストは、細菌のフラジェリンまたはその変異型である。 In another embodiment, a TLR agonist is used that is capable of causing a signaling response through TLR-5 (Sabroe et al., JI 2003 p1630-5). Suitably, the TLR agonist capable of causing a signaling response through TLR-5 is bacterial flagellin or a variant thereof.
前記のTLR-5アゴニストはフラジェリンであってもよく、またはTLR-5アゴニスト活性を保持したフラジェリンの断片であってもよい。フラジェリンは、H. pylori、S. typhimurium、V. cholera、S. marcesens、S. flexneri、T. pallidum、L. pneumophilia、B. burgdorferei、C. difficile、R. meliloti、A. tumefaciens、R. lupine、B. clarridgeiae、P. mirabilis、B. subtilus、L. moncytogenes、P. aeruginosaおよびE. coliからなる群より選択されるポリペプチドを含み得る。 The TLR-5 agonist may be flagellin or a fragment of flagellin that retains TLR-5 agonist activity. Flagellin is H. pylori, S. typhimurium, V. cholera, S. marcesens, S. flexneri, T. pallidum, L. pneumophilia, B. burgdorferei, C. difficile, R. meliloti, A. tumefaciens, R. lupine A polypeptide selected from the group consisting of: B. clarridgeiae, P. mirabilis, B. subtilus, L. moncytogenes, P. aeruginosa and E. coli.
特定の実施形態では、フラジェリンは、S. typhimuriumフラジェリンB(Genbank 受入番号AF045151)、S. typhimuriumフラジェリンBの断片、E. coli FliC(Genbank受入番号AB028476)、E. coli FliCの断片、S. typhimuriumフラジェリンFliC(ATCC14028)およびS. typhimuriumフラジェリンFliCの断片からなる群より選択される。 In certain embodiments, the flagellin is S. typhimurium flagellin B (Genbank accession number AF045151), a fragment of S. typhimurium flagellin B, E. coli FliC (Genbank accession number AB028476), a fragment of E. coli FliC, S. typhimurium. Flagellin FliC (ATCC14028) and S. typhimurium flagellin FliC fragments are selected from the group consisting of.
特定の実施形態では、前記のTLR-5アゴニストは、WO2009/156405に記載されるような末端が切断されたフラジェリン、すなわち超可変ドメインが欠失されたフラジェリンである。この実施形態の1つの態様では、前記のTLR-5アゴニストは、FliCΔ174-400;FliCΔ161-405およびFliCΔ138-405からなる群より選択される。 In a particular embodiment, said TLR-5 agonist is a truncated flagellin as described in WO2009 / 156405, ie a flagellin in which the hypervariable domain has been deleted. In one aspect of this embodiment, the TLR-5 agonist is selected from the group consisting of FliC Δ174-400 ; FliC Δ161-405 and FliC Δ138-405 .
更なる実施形態では、前記のTLR-5アゴニストは、WO2009/128950に記載されるようなフラジェリンである。 In a further embodiment, said TLR-5 agonist is flagellin as described in WO2009 / 128950.
TLR-5アゴニストがフラジェリンの断片である場合、前記の断片はTLR5アゴニスト活性を保持し、従ってTLR-5活性化に関与するその配列部分を保持していなければならないことが理解されるであろう。フラジェリンのNH2およびCOOH末端ドメイン、具体的には例えば、Salmonellaではアミノ酸86〜92が、TLR-5の相互作用および活性化にとって重要であることが、当業者に知られている。 If the TLR-5 agonist is a fragment of flagellin, it will be understood that said fragment must retain TLR5 agonist activity and therefore must retain its sequence portion involved in TLR-5 activation. . It is known to those skilled in the art that the NH 2 and COOH terminal domains of flagellin, specifically amino acids 86-92 in Salmonella, for example, are important for TLR-5 interaction and activation.
別の実施形態では、TLR-6(Sabroeら、JI 2003 p1630-5)を介したシグナル伝達応答を引き起こすことができるTLRアゴニストが使用される。適切には、TLR-6を介したシグナル伝達応答を引き起こすことができるTLRアゴニストは、マイコバクテリアリポタンパク質、ジアシル化LP、およびフェノール可溶性モジュリンである。更なるTLR6アゴニストはWO2003043572に記載される。 In another embodiment, a TLR agonist is used that is capable of causing a signaling response through TLR-6 (Sabroe et al., JI 2003 p1630-5). Suitably, TLR agonists capable of triggering a signaling response through TLR-6 are mycobacterial lipoproteins, diacylated LPs, and phenol soluble modulins. Further TLR6 agonists are described in WO2003043572.
別の実施形態では、TLR-7(Sabroeら、JI 2003 p1630-5)を介したシグナル伝達応答を引き起こすことができるTLRアゴニストが使用される。適切には、TLR-7を介したシグナル伝達応答を引き起こすことができるTLRアゴニストは、一本鎖RNA(ssRNA)、N7位およびC8位でのグアノシンアナログであるロキソリビン、またはイミダゾキノリン化合物、またはその誘導体である。1つの実施形態では、TLRアゴニストはイミキモドである。更なるTLR7アゴニストはWO02085905に記載される。 In another embodiment, a TLR agonist is used that is capable of causing a signaling response through TLR-7 (Sabroe et al., JI 2003 p1630-5). Suitably, a TLR agonist capable of triggering a signaling response via TLR-7 is a single-stranded RNA (ssRNA), loxoribine, a guanosine analog at positions N7 and C8, or an imidazoquinoline compound, or its Is a derivative. In one embodiment, the TLR agonist is imiquimod. Further TLR7 agonists are described in WO02085905.
別の実施形態では、TLR-8(Sabroeら、JI 2003 p1630-5)を介したシグナル伝達応答を引き起こすことができるTLRアゴニストが使用される。適切には、TLR-8を介したシグナル伝達応答を引き起こすことができるTLRアゴニストは、一本鎖RNA(ssRNA)、抗ウイルス活性を有するイミダゾキノリン分子、例えばレシキモド(R848)であり;レシキモドはまたTLR-7によっても認識することができる。使用されうる他のTLR-8アゴニストは、WO2004071459に記載されるものを含む。 In another embodiment, a TLR agonist is used that is capable of causing a signaling response through TLR-8 (Sabroe et al., JI 2003 p1630-5). Suitably, a TLR agonist capable of triggering a signaling response via TLR-8 is a single-stranded RNA (ssRNA), an imidazoquinoline molecule with antiviral activity, such as resiquimod (R848); resiquimod is also It can also be recognized by TLR-7. Other TLR-8 agonists that can be used include those described in WO2004071459.
1つの実施形態では、TLR7/8アゴニストがイミダゾキノリン分子、特にリン脂質またホスホノ脂質基に共有結合したイミダゾキノリンである、本発明の免疫原性組成物が提供される。特定の実施形態では、本発明の免疫原性組成物はCRX642(WO2010/048520参照)を含有する。 In one embodiment, an immunogenic composition of the invention is provided wherein the TLR7 / 8 agonist is an imidazoquinoline molecule, particularly an imidazoquinoline covalently linked to a phospholipid or phosphonolipid group. In a particular embodiment, the immunogenic composition of the invention contains CRX642 (see WO2010 / 048520).
免疫刺激オリゴヌクレオチドまたは他の任意のToll様受容体(TLR)9アゴニストもまた使用されうる。本発明のアジュバントまたはワクチンまたは免疫原性組成物に使用するために好ましいオリゴヌクレオチドは、CpGを含んでいるオリゴヌクレオチドであり、好ましくは少なくとも3個、より好ましくは少なくとも6個以上のヌクレオチドで間隔を空けた2個以上のジヌクレオチドCpGモチーフを含んでいる。CpGモチーフはシトシンヌクレオチドに続くグアニンヌクレオチドである。本発明のCpGオリゴヌクレオチドは、通常デオキシヌクレオチドである。好ましい実施形態では、オリゴヌクレオチドのヌクレオチド間は、ホスホロジチオエート結合、またはより好ましくはホスホロチオエート結合であるが、ホスホジエステル結合および他のヌクレオチド間結合は本発明の範囲内である。混在したヌクレオチド間結合を有するオリゴヌクレオチドもまた、本発明の範囲内に含まれる。ホスホロチオエートオリゴヌクレオチドまたはホスホロジチオエートを生成する方法は、US5,666,153、US5,278,302およびWO95/26204に記載される。 Immunostimulatory oligonucleotides or any other Toll-like receptor (TLR) 9 agonist can also be used. Preferred oligonucleotides for use in the adjuvants or vaccines or immunogenic compositions of the invention are those comprising CpG, preferably at least 3, more preferably at least 6 nucleotides apart. Contains two or more empty dinucleotide CpG motifs. The CpG motif is a guanine nucleotide following a cytosine nucleotide. The CpG oligonucleotide of the present invention is usually a deoxynucleotide. In preferred embodiments, the internucleotide nucleotides of the oligonucleotide are phosphorodithioate linkages, or more preferably phosphorothioate linkages, although phosphodiester linkages and other internucleotide linkages are within the scope of the invention. Oligonucleotides having mixed internucleotide linkages are also included within the scope of the present invention. Methods for producing phosphorothioate oligonucleotides or phosphorodithioate are described in US5,666,153, US5,278,302 and WO95 / 26204.
本発明に使用されるCpGオリゴヌクレオチドは、当技術分野において公知の任意の方法によって合成されうる(例えばEP 468520参照)。便宜的には、このようなオリゴヌクレオチドは自動合成装置を用いて合成されうる。 CpG oligonucleotides used in the present invention can be synthesized by any method known in the art (see, eg, EP 468520). Conveniently, such oligonucleotides can be synthesized using an automated synthesizer.
従って、別の実施形態では、アジュバント組成物は更に、TLR-1 アゴニスト、TLR-2アゴニスト、TLR-3アゴニスト、TLR-4アゴニスト、TLR-5アゴニスト、TLR-6 アゴニスト、TLR-7アゴニスト、TLR-8アゴニスト、TLR-9アゴニスト、またはそれらの組合せからなる群より選択される更なる免疫刺激剤を含有する。 Thus, in another embodiment, the adjuvant composition further comprises a TLR-1 agonist, a TLR-2 agonist, a TLR-3 agonist, a TLR-4 agonist, a TLR-5 agonist, a TLR-6 agonist, a TLR-7 agonist, a TLR. A further immunostimulatory agent selected from the group consisting of -8 agonists, TLR-9 agonists, or combinations thereof.
本発明の特定の実施形態では、TLRアゴニスト、またはTLRアゴニストの組合せの中の少なくとも1つのTLRアゴニストが合成物である、本発明の免疫原性組成物が提供される。「合成」とは、TLRアゴニストが天然に生じたものではないことを意味する。 In certain embodiments of the invention, there are provided immunogenic compositions of the invention, wherein at least one TLR agonist in a TLR agonist, or combination of TLR agonists is a synthetic. “Synthetic” means that the TLR agonist is not naturally occurring.
本発明の免疫原性組成物は、更なる免疫刺激剤、例えばQuil Aおよびその誘導体などのサポニンを含有しうる。Quil Aは、南米の樹木Quilaja Saponaria Molinaから分離されたサポニン調製物であり、Dalsgaardらによって1974年にアジュバント活性を有するとして最初に記載された(“Saponin adjuvants”, Archiv. fur die gesamte Virusforschung, Vol. 44, Springer Verlag, Berlin, p243-254)。Quil Aに関連した毒性を持たずにアジュバント活性を保持する精製されたQuil Aの断片、例えばQS7およびQS21(QA7およびQA21としても知られている)は、HPLCによって単離されている(EP 0 362 278)。QS-21は、Quillaja saponaria Molinaの樹皮に由来する天然のサポニンであり、それはCD8+細胞傷害性T細胞(CTL)、Th1細胞および顕著なIgG2a抗体応答を誘導し、本発明において好ましいサポニンである。 The immunogenic composition of the present invention may contain additional immunostimulatory agents such as saponins such as Quil A and its derivatives. Quil A is a saponin preparation isolated from the South American tree Quilaja Saponaria Molina and was first described by Dalsgaard et al. In 1974 as having adjuvant activity (“Saponin adjuvants”, Archiv. Fur die gesamte Virusforschung, Vol. 44, Springer Verlag, Berlin, p243-254). Purified Quil A fragments, such as QS7 and QS21 (also known as QA7 and QA21) that retain adjuvant activity without the toxicity associated with Quil A, have been isolated by HPLC (EP 0 362 278). QS-21 is a natural saponin derived from the bark of Quillaja saponaria Molina, which induces CD8 + cytotoxic T cells (CTL), Th1 cells and significant IgG2a antibody responses and is a preferred saponin in the present invention.
本発明の免疫原性組成物は医薬に使用するために適しており、従って、本明細書に記載されるような免疫原性組成物は、医薬に使用するために提供される。 The immunogenic compositions of the present invention are suitable for use in medicine, and thus immunogenic compositions as described herein are provided for use in medicine.
更なる実施形態では、本明細書に記載されるような免疫原性組成物は、特にヒトに対して、前記の組成物を経口投与(特に舌下投与)するステップを含む免疫方法に使用するために提供される。 In a further embodiment, an immunogenic composition as described herein is used in an immunization method comprising the step of orally administering (especially sublingual) said composition, particularly to a human. Provided for.
更なる実施形態では、本明細書に記載されるような免疫原性組成物は、特にヒトにおける疾患の予防および/または治療に使用するために提供される。 In further embodiments, immunogenic compositions as described herein are provided for use in the prevention and / or treatment of diseases, particularly in humans.
更なる実施形態では、特にヒトにおける疾患の予防および/または治療のための薬剤の製造における、本明細書に記載されるような免疫原性組成物の使用が提供される。 In a further embodiment, there is provided the use of an immunogenic composition as described herein, particularly in the manufacture of a medicament for the prevention and / or treatment of a disease in humans.
本発明の「ワクチン組成物」に関する本明細書の実施形態はまた、本発明の「免疫原性組成物」に関する実施形態にも適用でき、その逆もまた同様である。 Embodiments herein relating to “vaccine compositions” of the present invention are also applicable to embodiments relating to “immunogenic compositions” of the present invention, and vice versa.
本明細書における「含む(“comprising”, “comprise”および“comprises”)」という用語は、いかなる場合においても、「からなる(“consisting of”, “consist of”および“consists of”)」という用語と任意に置き換え可能であることを、本発明者らは意図している。 In this specification, the term “comprising”, “comprise” and “comprises” is in any case referred to as “consisting of”, “consisting of” and “consists of”. We intend that the terms can be arbitrarily replaced.
材料および方法
動物モデルおよびワクチン投与
6〜8週齢のメスBALB/c マウスをCharles Rivers Canadaから入手した。舌下免疫付与のために、ケタミンおよびキシラジンのi.p.注射によってマウスを麻酔した。マイクロピペットによってワクチンを投与した。飲み込みの影響を避けるため、Agとアジュバントの総量を8μlに抑えた。i.m.注射は、50μlの量で大腿筋に行われた。0日目および14日目にマウスを免疫し、28日目に屠殺した。
Materials and methods
Animal models and vaccine administration
6-8 week old female BALB / c mice were obtained from Charles Rivers Canada. For sublingual immunization, mice were anesthetized by ip injection of ketamine and xylazine. The vaccine was administered by micropipette. To avoid the effects of swallowing, the total amount of Ag and adjuvant was kept at 8 μl. Im injections were made in the thigh muscles in a volume of 50 μl. Mice were immunized on days 0 and 14 and sacrificed on day 28.
血清IgG ELISA
最後の免疫付与の2週間後(28日目)に最終採血を行った。特異的IgG定量および機能的な血清抗体の存在のために血清を採取した。コーティング抗原として界面活性剤スプリットA/SI/3/2006を用いたELISAによって、マウスの抗A/Solomon/Island/3/2006 (A/SI/3/2006) IgG抗体の定量を行った。スプリットFlu抗原をコーティングバッファー(0.05M 炭酸/重炭酸、pH 9.6)で0.5μg/ml(25ng/50μl)の最終濃度に希釈し、AffiniPureヤギ抗マウスIgG Fc-γ断片特異的抗体(Jackson Immuno Research)をコーティングバッファーで1.0μg/mL(50ng/50μl)の最終濃度に希釈した。コーティング抗原と捕捉抗体を平底96ウェルポリスチレンプレート(Maxisorp, Nunc)上に4時間、20℃で吸着させた。インキュベーション後、プレートをDPBS(Ca2+またはMg2+を含まないダルベッコリン酸緩衝生理食塩水;Gibco)/0.05%Tween 20(Sigma)で4回洗浄した。その後、1%ウシ血清アルブミン(BSA, Sigma)を含有するDPBSとともに、プレートを20℃で1時間インキュベートした。PBS、0.05%Tween 20および1%BSAを含有するバッファー(サンプル希釈バッファー)に血清を希釈し、その後、スプリットFluコーティングプレートに段階希釈して添加し、4℃で16〜18時間インキュベートした。インキュベーション後、プレートをPBS/0.05%Tween 20で4回洗浄した。その後、二次抗体である、サンプル希釈バッファーで1/10000に希釈したペルオキシダーゼコンジュゲートAffiniPureヤギ抗マウスIgG(Fc-γ断片特異的)をそれぞれのウェルに添加し、37℃で30分間インキュベートした。洗浄ステップ(PBS/0.05%Tween 20)後、プレートをTMBペルオキシダーゼ基質(BD Biosciences)とともに20℃で30分間インキュベートした。1M H2SO4で反応を停止させ、450nmで測定した。特異的血清IgG濃度は、SoftMaxPro によって4変数方程式を用いて標準から計算し、ng/mlで表した。
Serum IgG ELISA
The final blood was collected 2 weeks after the last immunization (day 28). Serum was collected for specific IgG quantification and the presence of functional serum antibodies. Mouse anti-A / Solomon / Island / 3/2006 (A / SI / 3/2006) IgG antibodies were quantified by ELISA using the surfactant split A / SI / 3/2006 as the coating antigen. Split Flu antigen is diluted to a final concentration of 0.5 μg / ml (25 ng / 50 μl) with coating buffer (0.05 M carbonate / bicarbonate, pH 9.6) and AffiniPure goat anti-mouse IgG Fc-γ fragment specific antibody (Jackson Immuno Research ) Was diluted with coating buffer to a final concentration of 1.0 μg / mL (50 ng / 50 μl). The coating antigen and the capture antibody were adsorbed on a flat bottom 96 well polystyrene plate (Maxisorp, Nunc) for 4 hours at 20 ° C. After incubation, the plates were washed 4 times with DPBS (Dulbecco phosphate buffered saline without Ca 2+ or Mg 2+ ; Gibco) /0.05% Tween 20 (Sigma). The plates were then incubated for 1 hour at 20 ° C. with DPBS containing 1% bovine serum albumin (BSA, Sigma). Serum was diluted in buffer (sample dilution buffer) containing PBS, 0.05
粘膜サンプル調製
2回目の免疫付与の2週間後、抗原特異的IgA抗体の定量のために、気管支肺胞洗浄(BAL)、鼻洗浄、唾液、膣洗浄および糞便を採取した。BALおよび鼻洗浄サンプルは、直接IgA定量のために試験された。唾液サンプルは、プロテアーゼ阻害剤混合物(PIC)の錠剤complete mini(Roche)を含有する300μLのサンプル希釈バッファーを添加することによって綿棒から抽出され、試験する前に15秒間2回、サンプルをボルテックスした。膣洗浄サンプルは、PICおよびブロメライン(25μg/mL)(Sigma)を含有する200μLのサンプル希釈バッファーに希釈され、37℃で1時間インキュベートされ、評価される前に15秒間ボルテックスされた。糞塊は、PIC含有サンプル希釈バッファーの添加までドライアイス上に置かれた。糞便の重さを量り、mgでのそれらの重量の5倍に相当するμLの容量に再懸濁した。サンプルをホモジナイズし(Kontesホモジナイザー)、4℃、7300rpmで5分間遠心分離した。上清を回収し、ELISAによって評価した。
Mucosal sample preparation
Two weeks after the second immunization, bronchoalveolar lavage (BAL), nasal lavage, saliva, vaginal lavage and stool were collected for quantification of antigen-specific IgA antibodies. BAL and nasal wash samples were tested for direct IgA quantification. Saliva samples were extracted from the swabs by adding 300 μL of sample dilution buffer containing the protease inhibitor mixture (PIC) tablet complete mini (Roche), and the samples were vortexed twice for 15 seconds before testing. Vaginal lavage samples were diluted in 200 μL of sample dilution buffer containing PIC and bromelain (25 μg / mL) (Sigma), incubated for 1 hour at 37 ° C., and vortexed for 15 seconds before being evaluated. Feces were placed on dry ice until the addition of PIC-containing sample dilution buffer. Feces were weighed and resuspended in a volume of μL corresponding to 5 times their weight in mg. Samples were homogenized (Kontes homogenizer) and centrifuged at 7300 rpm for 5 minutes at 4 ° C. The supernatant was collected and evaluated by ELISA.
IgA ELISA
血清IgG定量について記載されたものと同様のELISAによって、マウスの抗A/SI/3/2006 IgA抗体の定量を行った。より具体的には、コーティングバッファー(0.05M 炭酸/重炭酸、pH 9.6)で2 μg/ml(100ng/50μl)の最終濃度に希釈されたスプリットFlu抗原およびコーティングバッファーで1.0μg/mL(50ng/50μl)の最終濃度に希釈されたヤギ抗マウスIgA(α鎖特異的)(Sigma)を用いて、コーティングを行った。一晩置きブロッキングステップ後、粘膜サンプルをスプリットFluコーティングプレートに段階希釈して添加し、4℃で16〜18時間インキュベートした。インキュベーション後、二次抗体である、サンプル希釈バッファーで1/6000に希釈したペルオキシダーゼコンジュゲートAffiniPureヤギ抗マウスIgA(α鎖特異的)をそれぞれのウェルに添加し、37℃で30分間インキュベートした。TMBペルオキシダーゼ基質(BD Biosciences)とともにインキュベーション後、1M H2SO4で反応を停止させ、450nmで測定した。IgA濃度は、SoftMaxPro によって4変数方程式を用いて標準から計算され、ng/mlで表された。
IgA ELISA
Mouse anti-A / SI / 3/2006 IgA antibodies were quantified by an ELISA similar to that described for serum IgG quantification. More specifically, split Flu antigen diluted to a final concentration of 2 μg / ml (100 ng / 50 μl) with coating buffer (0.05 M carbonate / bicarbonate, pH 9.6) and 1.0 μg / mL (50 ng / mL) with coating buffer. Coating was performed using goat anti-mouse IgA (α chain specific) (Sigma) diluted to a final concentration of 50 μl). After an overnight blocking step, mucosal samples were serially diluted and added to split Flu coated plates and incubated at 4 ° C. for 16-18 hours. After incubation, a secondary antibody, peroxidase-conjugated AffiniPure goat anti-mouse IgA (α chain specific) diluted 1/6000 in sample dilution buffer, was added to each well and incubated at 37 ° C. for 30 minutes. After incubation with TMB peroxidase substrate (BD Biosciences), the reaction was stopped with 1M H 2 SO 4 and measured at 450 nm. The IgA concentration was calculated from the standard using the 4-variable equation by SoftMaxPro and expressed in ng / ml.
赤血球凝集抑制(HI)アッセイ
2回目の免疫付与の2週間後に採取された個々の血清に対して、HIアッセイを行った。受容体破壊酵素(Sigma)による一晩の処理によって、非特異的阻害剤を血清から除去した。その後、カルシウム生理食塩水(Calcium saline solution)を加えて1:10希釈を行い、続いてニワトリまたはオンドリブタ(rooster pig)赤血球の50%(v/v)溶液とともに4℃で60分間インキュベートして非特異的凝集素を除去した。処理された血清を25μlのPBSに段階希釈し、その後、株特異的インフルエンザ抗原(8赤血球凝集素ユニットを有する全ウイルス)を含有する同量のPBSとともに45分間室温でインキュベートした。ニワトリまたはオンドリの成鳥から得られた赤血球の0.5%v/v懸濁液を添加し、混合物を更に45分間インキュベートした。反応に続いて目視検査が行われ:赤い点の形成は陽性反応(抑制)を示し、細胞の広範な斑点は陰性反応(赤血球凝集)を示す。陰性対照として、また、アッセイのバックグラウンド値を測定するために、バッファーで免疫されたマウスの血清サンプルを同時に試験した。すべての血清は二連で行われた。HAI力価は、赤血球凝集を抑制した最後の希釈の逆数として記録された。
Hemagglutination inhibition (HI) assay
HI assays were performed on individual sera collected 2 weeks after the second immunization. Non-specific inhibitors were removed from the serum by overnight treatment with receptor destroying enzyme (Sigma). Then, add 1:10 dilution with calcium saline solution, and then incubate with 50% (v / v) solution of chicken or rooster pig erythrocytes at 4 ° C for 60 min. Specific agglutinin was removed. Treated sera were serially diluted in 25 μl of PBS and then incubated for 45 minutes at room temperature with the same volume of PBS containing strain-specific influenza antigen (total virus with 8 hemagglutinin units). A 0.5% v / v suspension of red blood cells obtained from adult chickens or roosters was added and the mixture was incubated for an additional 45 minutes. The reaction is followed by visual inspection: the formation of red dots indicates a positive response (suppression), and extensive spots of cells indicate a negative response (erythrocyte aggregation). As a negative control and to measure the background value of the assay, serum samples from mice immunized with buffer were tested simultaneously. All sera were performed in duplicate. HAI titers were recorded as the reciprocal of the last dilution that inhibited hemagglutination.
統計解析
すべての統計解析は下記のように行われた。値は対数に変換され、シャピロ‐ウィルク正規性検定を用いてガウス分布について解析された。群の大部分が正規分布または許容限度内の歪度(-1≦1)および尖度(-1≦2)の値を有する場合、一元配置分散分析およびダンネットの多重比較検定を行った。他の場合は、クラスカル‐ウォリス分散分析およびダンの多重比較検定を行った。
Statistical analysis All statistical analyzes were performed as follows. Values were converted to logarithm and analyzed for Gaussian distribution using the Shapiro-Wilk normality test. One-way analysis of variance and Dunnet's multiple comparison test were performed when the majority of the groups had normal distribution or skewness (-1 ≦ 1) and kurtosis (-1 ≦ 2) values within acceptable limits. In other cases, Kruskal-Wallis analysis of variance and Dunn's multiple comparison test were performed.
結果および考察
舌下ワクチン接種の有効性を決定するために、TLR2および4アゴニストによって免疫補助された、モデル抗原としてインフルエンザ抗原を用いた新規ワクチン製剤を、全身性免疫応答および粘膜免疫応答を誘導するそれらの能力について試験した。細菌由来のTLR2/4アゴニストであるShigella flexineri外膜タンパク質調製物(SFOMP)、およびTLR2アゴニストである合成リポペプチドPam3CysLipを最初に評価した。BALB/cマウスを、舌下経路によって、SFOMP(5μg)、Pam3CysLip(10μg)、またはコレラ毒素(CT)のいずれかによって免疫補助された界面活性剤スプリットA/SI/3/2006ウイルスを用いて、2週間間隔で2回免疫した。最後の免疫付与の2週間後、ウイルス特異的抗体のレベルを、ELISAおよびHIアッセイによって測定した。A/Solomon Island特異的な血清IgG抗体は、SFOMPまたはPam3CysLipによって免疫補助されたスプリット抗原で免疫された麻酔動物で検出された。免疫補助製剤で舌下免疫されたすべてのマウスは、筋肉内ワクチン接種群と統計的に同様のIgGレベルを示した(図1)。7μgの抗原のPam3CysLipによる免疫補助または14μgの抗原のSFOMPによる免疫補助は、免疫補助されていないワクチンと比較した場合、IgGレベルが有意に増加した。血清IgGの機能性はHIアッセイによって実証され、図1に示されるように、舌下ワクチンの免疫補助は、理論的には最低でも防御の60%に関与するHIアッセイ力価をもたらした。このデータは、舌下免疫においてTLR2/4アゴニストを使用できる可能性を示唆した。
Results and discussion : To determine the efficacy of sublingual vaccination, a novel vaccine formulation with influenza antigen as a model antigen, immunized by TLR2 and 4 agonists, induces systemic and mucosal immune responses They were tested for their ability. Shigella flexineri outer membrane protein preparation (SFOMP), a bacterial TLR2 / 4 agonist, and the synthetic lipopeptide Pam3CysLip, a TLR2 agonist, were first evaluated. BALB / c mice with detergent split A / SI / 3/2006 virus immunized by either sublingual route, either SFOMP (5 μg), Pam3CysLip (10 μg), or cholera toxin (CT) Immunized twice at 2-week intervals. Two weeks after the last immunization, the level of virus-specific antibodies was measured by ELISA and HI assay. A / Solomon Island-specific serum IgG antibodies were detected in anesthetized animals immunized with split antigen immunized with SFOMP or Pam3CysLip. All mice immunized sublingually with the immunosuppressant formulation showed IgG levels that were statistically similar to the intramuscular vaccinated group (FIG. 1). Assistance with 7 μg of antigen with Pam3CysLip or with 14 μg of antigen with SFOMP significantly increased IgG levels when compared to vaccines without immunosuppression. Serum IgG functionality was demonstrated by HI assay, and as shown in FIG. 1, sublingual vaccine immune support resulted in HI assay titers that theoretically involved at least 60% of protection. This data suggested the possibility of using TLR2 / 4 agonists in sublingual immunity.
舌下ワクチン接種におけるTLR2および/またはTLR4アゴニストの可能性を確かめるために、純粋な合成TLR4アゴニスト(CRX527)を単独で、または純粋なTLR2アゴニスト(Pam3CysLip)と組み合わせて使用した。CRX527は、標準的な免疫付与レジメンにおいて1μgの用量で試験された。血清IgG ELISA分析は、TLR4アゴニストCRX-527(1μg)±TLR2アゴニストPam3CysLip(5μg)およびスプリットインフルエンザ抗原を含有するワクチン製剤が、舌下免疫付与後の抗原‐特異的血清IgG応答の誘導に有効であることを示した(図2)。この研究では、舌下ワクチンの免疫補助効果は、それぞれのアジュバントで観察された。HIアッセイでは、ワクチンの舌下投与後の機能的な血清抗体の存在が確認された。同一群のマウス内での応答のばらつきの大きさにもかかわらず、血清IgGレベルとHI力価との間には良好な関連性があった。 To confirm the potential of TLR2 and / or TLR4 agonists in sublingual vaccination, a pure synthetic TLR4 agonist (CRX527) was used alone or in combination with a pure TLR2 agonist (Pam3CysLip). CRX527 was tested at a dose of 1 μg in a standard immunization regimen. Serum IgG ELISA analysis shows that a vaccine formulation containing the TLR4 agonist CRX-527 (1 μg) ± TLR2 agonist Pam3CysLip (5 μg) and split influenza antigen is effective in inducing an antigen-specific serum IgG response after sublingual immunization. It was shown (FIG. 2). In this study, the immunosuppressive effect of the sublingual vaccine was observed with each adjuvant. The HI assay confirmed the presence of functional serum antibodies after sublingual administration of the vaccine. Despite the magnitude of response variability within the same group of mice, there was a good association between serum IgG levels and HI titers.
試験されたモデル抗原に対する関連部位での粘膜抗体応答を評価するため、BAL、鼻洗浄および唾液を、抗原特異的IgA抗体の定量のために採取した。加えて、舌下経路によって誘導される粘膜免疫応答の範囲を調べるために、膣洗浄および糞便を採取した。IgA ELISA分析は、TLR4アゴニスト±TLR2アゴニストに基づくA/SI/3/2006ワクチン製剤が、舌下投与された際の粘膜免疫応答の誘導に有効であることを示した。表1に示されるように、抗原特異的IgAは、すべての粘膜部位で検出され、膣洗浄および糞塊サンプルにおいて最も高いレベルであった。免疫補助されていない製剤を含む、いずれの舌下送達ワクチンも、糞便中に抗原特異的応答を誘導した。Solomon Islands界面活性剤スプリット抗原の免疫補助は、少なくとも2倍の抗原特異的IgAレベルの増加を示した。
有効な抗原/アジュバントワクチン製剤を同定するために、7種のアジュバント候補(1μg用量)で免疫補助されたA/SI/3/2006界面活性剤スプリット抗原を用いて、舌下免疫原性試験を行った。舌下免疫付与の成功を決定するための基準として、筋肉内(IM)免疫付与を行った。市販されているFluワクチンは1回で済むワクチンとして投与されるため、筋肉内免疫付与は、1回目の免疫の日、または2回目の免疫の日のいずれかで1回投与された。 To identify effective antigen / adjuvant vaccine formulations, sublingual immunogenicity studies were performed using A / SI / 3/2006 surfactant split antigens immunized with 7 adjuvant candidates (1 μg dose). went. Intramuscular (IM) immunization was performed as a basis for determining the success of sublingual immunization. Since the commercially available Flu vaccine is administered as a single vaccine, intramuscular immunization was administered once on either the first immunization day or the second immunization day.
血清IgG ELISA分析は、舌下送達される免疫補助されていないFluワクチンの2回の滴下が、特異的血清IgG応答を誘導できることを示した(GMC=5267 ng/mL)(図3)。SFOMP(GMC=28771ng/mL)、Pam3CysLip(GMC=40731ng/mL)、またはCT(GMC=42343ng/mL)によるFluワクチンの免疫補助は、0日目または14日目のいずれかに1回投与された筋肉内免疫と同様の特異的IgGレベルを誘導した。免疫補助されていない舌下Fluワクチンと比較して血清中で5.5×および7.7×のIgG産生の増加を誘導する、SFOMPまたはPam3CysLipによる免疫補助に加えて、CRX642(GMC=23966 ng/mL)もまたアジュバント効果を示し、有意に高い(4.6×)IgGレベルを誘導できた。機能的な血清抗体(HI力価≧40)は、舌下免疫後に誘導されることができた。動物を免疫補助されていないワクチンで2回免疫した場合、1/40の動物がHI力価≧40を示した。機能的な抗体を有するマウス数の増加は、SFOMP(4/20)、Pam3CysLip(4/20)、CRX642(4/20)またはCT (7/20)によって免疫補助されたワクチン製剤において観察された。flu 抗原とともにSFOMP±Pam3CysLipを用いた1回目の舌下試験において観察された力価と比較したこれらのHI力価の相違は、恐らく免疫経路のためである。前述のように、同一群の動物内で、高い変動係数が常に観察される。この欠点を克服するためには、粘膜付着性化合物とともに抗原を製剤化することが計画される。
舌下免疫後の粘膜免疫応答を、いくつかの粘膜液におけるIgA ELISAによって調べた。IM免疫付与とは対照的に、免疫補助されたスプリットインフルエンザ抗原による舌下免疫付与は、BAL、鼻洗浄、唾液、膣洗浄および糞便において抗原特異的IgAを誘導する。モデル抗原としてFluを用いて、試験されたモデル抗原に対する関連部位での粘膜抗体応答の舌下免疫付与における成功基準は、肺液、鼻洗浄および唾液におけるIgA応答を必要とする。
Serum IgG ELISA analysis showed that 2 drops of non-immuno-assisted Flu vaccine delivered sublingually could induce a specific serum IgG response (GMC = 5267 ng / mL) (FIG. 3). Flu vaccine support with SFOMP (GMC = 28771ng / mL), Pam3CysLip (GMC = 40731ng / mL), or CT (GMC = 42343ng / mL) is administered once on either day 0 or 14 Induced specific IgG levels similar to intramuscular immunity. In addition to immune assistance with SFOMP or Pam3CysLip, which induces increased 5.5x and 7.7x IgG production in serum compared to non-immunosubjugated sublingual Flu vaccine, CRX642 (GMC = 23966 ng / mL) It also showed an adjuvant effect and was able to induce significantly higher (4.6 ×) IgG levels. A functional serum antibody (HI titer ≧ 40) could be induced after sublingual immunization. When animals were immunized twice with a non-immune-assisted vaccine, 1/40 animals showed HI titers ≧ 40. An increase in the number of mice with functional antibodies was observed in vaccine formulations immunized by SFOMP (4/20), Pam3CysLip (4/20), CRX642 (4/20) or CT (7/20) . The difference in these HI titers compared to the titers observed in the first sublingual test using SFOMP ± Pam3CysLip with the flu antigen is probably due to the immune pathway. As mentioned above, a high coefficient of variation is always observed within the same group of animals. To overcome this drawback, it is planned to formulate the antigen with a mucoadhesive compound.
The mucosal immune response after sublingual immunization was examined by IgA ELISA in several mucosal fluids. In contrast to IM immunization, sublingual immunization with immune-assisted split influenza antigen induces antigen-specific IgA in BAL, nasal lavage, saliva, vaginal lavage and stool. Success criteria in sublingual immunization of mucosal antibody responses at relevant sites against model antigens tested using Flu as model antigens require IgA responses in lung fluid, nasal lavage and saliva.
BAL分析は、舌下ワクチン接種後の肺液において低レベルの特異的IgAが見出されることを示した(表2)。最も高いIgA応答は、CTによって免疫補助されたfluワクチン(GMC=9.75 ng/mL)で免疫された動物において観察された。CTに加えて、Pam3CysLip(GMC=3.95 ng/mL)、フラジェリン(GMC=4.04 ng/mL)およびCpG(GMC=4.10 ng/mL)によって免疫補助されたワクチンは、クラスカル‐ウォリスおよびダンの多重比較検定に基づき、IM免疫付与より有意に高いBAL IgAレベルを誘導する。鼻洗浄分析は、舌下ワクチン接種後の鼻洗浄において低レベルの特異的IgAが見出されることを示した。BALと同様に、最も高いIgA応答は、CTによって免疫補助されたfluワクチン(GMC=12.91 ng/mL)で免疫された動物において観察された。CTに加えて、CpG(GMC=4.33 ng/mL)によって免疫補助されたワクチンだけが、クラスカル‐ウォリスおよびダンの多重比較検定に基づき、IM免疫付与より有意に高い鼻洗浄IgAレベルを誘導する。CTは、免疫補助されていない舌下fluワクチンと比較して、鼻洗浄で有意に高いIgAレベルを誘導する唯一の試験アジュバントであった。唾液分析は、舌下ワクチン接種後の唾液において低レベルの特異的IgAが見出されることを示した。BALおよび鼻洗浄と同様に、最も高いIgA応答は、CTによって免疫補助されたfluワクチン(GMC=6.00 ng/mL)で免疫された動物において観察された。CTに加えて、Pam3CysLip(GMC=4.13/mL)によって免疫補助されたワクチンは、一元配置分散分析およびダンネットの多重比較検定に基づき、IM免疫付与より有意に高い唾液IgAレベルを誘導する。試験されたモデル抗原に対する関連部位での粘膜抗体応答の舌下免疫付与における成功基準によれば、CpG、Pam3CysLipおよびフラジェリンは有望な候補となる。
膣洗浄分析は、舌下ワクチン接種後の膣分泌物においてより高レベルの特異的IgAが検出され得ることを示した。前述のように、IgAはIM免疫後には検出されず、バックグラウンドレベルはGMC=3.54 ng/mLに設定された。免疫補助されていない舌下Fluワクチンは、IM免疫付与と比較して2.2倍高いIgAレベル(GMC=7.76ng/mL)を誘導することができた。SFOMP、Pam3CysLip、CRX642またはフラジェリンによる免疫補助は、IgA応答を大きく増加させ、従って、膣分泌物中にIgAを必要とする抗原に対する有望なアジュバント候補となる。しかし、適切な抗原を用いた更なる研究が必要とされる。特異的IgAはまた、舌下ワクチン接種後の糞便においても検出することができた。免疫補助されていない舌下ワクチンは、IM免疫付与と同様の糞便IgAレベルを誘導した。表2に示されるように、CTによる免疫補助だけが、IM免疫付与と比較してIgA応答を有意に増加させた。 Vaginal lavage analysis showed that higher levels of specific IgA could be detected in vaginal secretions after sublingual vaccination. As described above, IgA was not detected after IM immunization and the background level was set to GMC = 3.54 ng / mL. The sublingual Flu vaccine without immune assistance was able to induce IgA levels (GMC = 7.76 ng / mL) 2.2 times higher compared to IM immunization. Immune support with SFOMP, Pam3CysLip, CRX642 or flagellin greatly increases the IgA response and is therefore a promising adjuvant candidate for antigens that require IgA in vaginal secretions. However, further studies with appropriate antigens are needed. Specific IgA could also be detected in stool after sublingual vaccination. The sublingual vaccine without immune assistance induced fecal IgA levels similar to IM immunization. As shown in Table 2, only immune support with CT significantly increased the IgA response compared to IM immunization.
結論
いくつかのアジュバントが、モデル抗原としてスプリットFlu A/Solomon Islandを用いたマウスの舌下免疫について試験された。有望なアジュバント候補は、SFOMPおよびPam3CysLipであることが示された。しかし、抗原濃度がまだ高すぎる可能性があり、CRX642は、より低い抗原用量では、期待できるアジュバントとなりうる。機能アッセイによれば、舌下免疫の有望なアジュバント候補は、SFOMP、Pam3CysLipおよびCRX642である。試験されたモデル抗原に対する関連部位での粘膜抗体応答の舌下免疫付与における成功基準によれば、CpG、Pam3CysLip、フラジェリンおよびCRX642は、有望な候補となる。CMI分析は、それらのTh1サイトカイン産生およびサイトカインパターンの項目では試験アジュバント間の識別を可能にしなかった。すべての基準を組み合わせると、舌下免疫付与のために最も期待できるアジュバントは、Pam3CysLip、CRX642およびフラジェリンである。
Conclusion Several adjuvants have been tested for sublingual immunization of mice using split Flu A / Solomon Island as a model antigen. Promising adjuvant candidates have been shown to be SFOMP and Pam3CysLip. However, the antigen concentration may still be too high and CRX642 can be a promising adjuvant at lower antigen doses. According to functional assays, promising adjuvant candidates for sublingual immunity are SFOMP, Pam3CysLip and CRX642. According to the success criteria in sublingual immunization of mucosal antibody responses at relevant sites against the model antigens tested, CpG, Pam3CysLip, flagellin and CRX642 are promising candidates. CMI analysis did not allow discrimination between test adjuvants in terms of their Th1 cytokine production and cytokine pattern. Combining all criteria, the most promising adjuvants for sublingual immunization are Pam3CysLip, CRX642 and flagellin.
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US (1) | US20130089570A1 (en) |
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WO2015050179A1 (en) | 2013-10-03 | 2015-04-09 | 日東電工株式会社 | Mucosal vaccine composition |
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WO2024004159A1 (en) * | 2022-06-30 | 2024-01-04 | Eps創薬株式会社 | Vaccine composition for sublingual administration |
Also Published As
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SG185729A1 (en) | 2012-12-28 |
MX2012014083A (en) | 2013-01-29 |
CA2801266A1 (en) | 2011-12-08 |
AU2011260215B2 (en) | 2014-06-12 |
US20130089570A1 (en) | 2013-04-11 |
WO2011151431A1 (en) | 2011-12-08 |
EA201291105A1 (en) | 2013-05-30 |
AU2011260215A1 (en) | 2013-01-17 |
ZA201208915B (en) | 2014-04-30 |
CN102905726A (en) | 2013-01-30 |
BR112012030552A2 (en) | 2016-08-16 |
GB201009273D0 (en) | 2010-07-21 |
KR20130082139A (en) | 2013-07-18 |
IL223151A0 (en) | 2013-02-03 |
EP2575871A1 (en) | 2013-04-10 |
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